The Department of Health Care Services (DHCS) released the final Health Risk Assessment (HRA) plan letters creating a new standardized set of long-term services and supports (LTSS) referral questions for Cal MediConnect and Medi-Cal plans to use with Californians who are dual eligible beneficiaries or Medi-Cal Seniors and Persons with Disabilities. Plans must begin using these new questions in January 2018.
1) Medi-Cal All Plan Letter (APL) titled “Care Coordination Requirements for Managed Long-Term Services and Supports” (APL 17-012)
2) Medi-Cal APL titled “Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities” (APL 17-013)
3) Cal MediConnect Duals Plan Letter (DPL) titled “Health Risk Assessment and Risk Stratification Requirements for Cal MediConnect” (DPL 17-001)
In 2016, DHCS announced it would be pursuing a comprehensive strategy to strengthen the Coordinated Care Initiative and Cal MediConnect. One of the key areas DHCS focused on was improving referrals to LTSS. The effort included creating standardized LTSS referral questions for all Cal MediConnect and Managed Long-Term Services and Supports (MLTSS) plans to use in their HRAs. To accomplish this, DHCS convened a workgroup of 20 participants from a variety of stakeholder groups, including advocates, LTSS providers, health plans, medical groups, and state agencies.
Click here for more information about the HRA LTSS workgroup and its process.